Individual
DOMINIQUE J BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
545 LANE AVE, JACKSON, TN 38301-4501
(731) 425-7668
Mailing address
213 TRACE DR, JACKSON, TN 38305-1580
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0000001877
TN
Other
Enumeration date
06/28/2017
Last updated
06/28/2017
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